Examples of QXQs[1]

Examples of QXQs – Instructions to the interviewer to explain questions to the participant

Hearing Exam Questionnaire

Question 13. What type of surgery was done?

1 Tympanoplasty

2 Mastoidectomy

3 Stapedectomy

4 Cochlear implant

5 Other

QXQ Explanation: Tympanoplasty is surgical correction of damage to the middle ear. Mastoidectomy involves the removal of the mastoid bone (behind the ear) and the opening of diseased mastoid air cells. A stapedectomy involves removal of a portion of the stapes bone (a small bone in the inner ear) and replacing it with a prosthesis to restore the ear’s ability to transmit sound. A cochlear implant is an electronic prosthesis, surgically implanted in the ear, that can restore a sense of sound to people with hearing impairment. Some participants may not be familiar with the medical term for their procedure. If the description the participant provides matches any of the descriptions for choices 1 – 4, code as such. If uncertain, or if the participant is unable to describe the procedure, record as 5.

Question 16. Have you ever had an acoustic neuroma?

No Yes Don’t know/refused

QXQ Explanation: An acoustic neuroma is a tumor on the auditory nerve. The participant may not be aware of the medical term. If he or she reports that they have had a tumor and that the tumor was on a nerve affecting their ear, code as yes. Tumors that are not on a nerve should be coded as no.

Question 17. Have you ever had a cholesteatoma?

No Yes Don’t know/refused

QXQ Explanation: A cholesteatoma is a mass or growth in the middle ear.

Question 18. Has a doctor ever told you that you have Meniere’s Disease?

No Yes Don’t know/refused

QXQ Explanation: Meniere’s Disease is a syndrome characterized by nausea, vomiting, tinnitus (ringing in the ears) and progressive hearing loss.

Question 19. Has a doctor ever told you that you have otosclerosis?

No Yes Don’t know/refused

QXQ Explanation: Otosclerosis is a disorder of the bones of the middle ear.

Medical History Questionnaire

Question 3. Has a doctor ever said that you have angina?

No 0 􀃆 GO TO QUESTION 3b

Yes 1

3a. At what age were you first told this?

_____ Age in years

Has a doctor ever said that these relatives had angina?

3b. Mother No or Don’t know 0 Yes 1

3c. Father No or Don’t know 0 Yes 1

3d. Brother(s) or sister(s) No or Don’t know 0 Yes 1

QXQ Explanation: Assess personal and family history of angina as well as respondent age at diagnosis for this condition. Chest pain is a hallmark symptom of persons with angina. However, not all persons who experience chest pain have this condition. Therefore, it is important to check the yes box on this set of questions only if they can state that a doctor told them they had angina.

Question 4. Has a doctor ever said that you had a heart attack?

No 0 􀃆 GO TO QUESTION 4b

Yes 1

QXQ Explanation: Assess personal and family history of heart attack. The clinical name for heart attack is myocardial infarction. Age when the heart attack occurred is obtained for both the respondent and for blood relatives. This latter information is important to ascertain because some studies suggest that history of heart attacks in family members that occur at relatively young ages is a risk factor for heart disease in other family members. Q4b-c assess history of doctor-diagnosed heart attack in biological parents, followed by the age at which first such occurred. Q4d assesses family history of heart attack in brother(s) or sister(s). In rare cases there may be more than one sibling with a history of heart attack. In this case record the younger age at which there was a heart attack. For example, if the respondent reported that a brother had a heart attack at age 50 and a sister had a heart attack at age 40, then you would record 40 as the age for item 4d.

Question 5. Has a doctor ever said that you had heart failure?

No 0

Yes 1

QXQ Explanation: Assess personal and family history of doctor diagnosed heart failure. Another clinical name for this condition is congestive heart failure or congestive cardiac failure. This diagnosis covers a variety of conditions in which the heart is unable to pump a sufficient amount of blood through the body. Heart failure should not be confused with heart attack or myocardial infarction.

Question 6. Has a doctor ever said that you had rheumatic heart disease?

No 0

Yes 1

QXQ Explanation: Assess personal and family history of doctor diagnosed rheumatic heart disease. Persons with this condition have damaged heart valves, which can be a consequence of untreated streptococcus infection that typically occurred in childhood.

Occupational Questionnaire

Question 23. At the job you currently work the majority of your work hours per week, how often are you exposed to any type of organic solvents, for example styrene, trichloroethylene, toluene, or xylene?

None of the time 1

25% of the time 2

50% 3

75% 4

100% 5

Occasionally 6

Don’t know 9

QXQ Explanation: Read as given, but if the participant is not familiar with what a given term means, (e.g., manganese) take this as a NO. Do not explain. People exposed will typically

know. Those needing an explanation are much less likely to actually come in

contact with these substances.

13. At what frequency will each of the instruments be used? For example, will the SF-12 questions be asked at follow-up or only at baseline?

Each instrument will be administered one time. Within the 3-year OMB period of approval for the collection, annual telephone follow-up will take place to maintain contact with the participants, verify addresses, ascertain vital status and to obtain information on medical events or hospitalizations and other life events since the baseline examination.

14. Will recruitment take place in person? (the recruitment script seems to imply an in-person screening visit).

The recruitment plan consists of three basic steps: